Healthcare Provider Details

I. General information

NPI: 1528043452
Provider Name (Legal Business Name): CAPITAL REGION PATHOLOGISTS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/14/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 NORTHERN BLVD
ALBANY NY
12204-1004
US

IV. Provider business mailing address

PO BOX 884
LATHAM NY
12110-0884
US

V. Phone/Fax

Practice location:
  • Phone: 518-471-3246
  • Fax:
Mailing address:
  • Phone: 518-786-1296
  • Fax: 518-786-1293

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number
License Number State

VIII. Authorized Official

Name: VERNON PILON
Title or Position: PRESIDENT
Credential: MD
Phone: 518-471-3246